Will hospital-insurer fight stall your cashless claims?

Maintain emergency fund but don't ditch insurance as you can always claim reimbursement

- Aprajita Sharma

The age-old uneasy relationship between hospitals and insurers is once again spilling into the open. Bajaj Allianz General Insurance and Care Health Insurance have recently had separate altercations with the Association of Healthcare Providers-India (AHPI) over delays in claim settlements, delays in empanelling new hospitals, unrevised package rates, demanding unnecessary documentation, and pressure to reduce tariffs. If you are a customer of these insurers, you may be wondering if you should port your policy to another provider.

Well, the good news is there's no need to panic.

Mint has learnt that Bajaj Allianz and Care Health have met AHPI separately to iron out their differences with member hospitals. The suspension of cashless services for Bajaj Allianz, which AHPI announced earlier this week, is expected to be revoked after both insurers address member hospitals' concerns and share a detailed plan about it with the association. Care Health was only warned about having its cashless services revoked.

Bajaj Allianz CEO Tapan Singhel clarified that no cashless claims have been denied so far since the AHPI's announcement.

General Insurance Council, a statutory body that represents the interests of general and health insurance companies, also condemned AHPI's suspension notice and demanded its immediate withdrawal, calling it an anti-consumer move.

A recurring flashpoint AHPI's decision to stop cashless treatment unfairly penalises policyholders, who bear the brunt of the standoff. This is hardly the first time policyholders have been caught in the crossfire. Star Health and Tata AIG previously faced similar action from hospital associations.

Experts, however, said no such notice has ever affected a policyholder directly as insurers negotiate with associations before the situation turns ugly.